Maricopa County law enforcement violated the constitutional rights of this newspaper's readers in October. Using secret grand jury subpoenas, County Attorney Andrew Thomas sought records that would reveal the identity of anyone who'd looked at New Times online in the past four years. When the paper's leaders revealed the grand jury probe in a cover story, sheriff's deputies arrested them.

The assault on New Times began in 2004 when the paper published Sheriff Joe Arpaio's address as part of an investigation into his hidden commercial real estate transactions. Arpaio demanded that the newspaper be prosecuted under an arcane statute that makes it illegal to publish law enforcement officers' addresses in cyberspace, even though that data is readily available on government Web sites and is perfectly legal to publish on newsprint.

Thomas responded by appointing a special prosecutor, who demanded not only the records and e-mails of the paper's writers and editors — but also sought sensitive information on the Internet-viewing habits of our readers. On October 18, New Times published a cover story revealing the invasive subpoenas.

That story violated grand jury secrecy statutes, but the revelations in the article, compounded by the subsequent arrest of Village Voice Media Executive Editor Michael Lacey and CEO Jim Larkin, sparked public outrage. County Attorney Thomas fired the special prosecutor and dropped all charges. He also abandoned the Arpaio-inspired probe of the paper.

As the smoke began to clear, this newspaper began a series, "Target Practice." The project sprang from a fundamental question: Why did law enforcement — the sheriff and the county attorney — believe they could force a newspaper to reveal the identities and habits of the publication's readers?

Our investigation has made one thing clear: Maricopa County's sheriff has a vivid history of ignoring the Constitution and the Bill of Rights. He's trampled the rights of prisoners, political enemies, and media critics. In partnership with the county attorney, the pair have expanded their enemies list to include the judiciary and immigrants. Private citizens and their Internet-viewing records were merely the latest victims in a long line.

Like most attorneys, Kathleen Carey leads a busy life. So she didn't take much time to examine what looked like a pimple on her arm. Twelve days later, Carey's arm had ballooned to nearly twice its normal size, and pus was oozing from a boil where the zit had been.

After $180,000 in medical bills, four doctors, and two hospitals, Carey learned that the supposed pimple was actually the flesh-eating "superbug" bacteria commonly known as MRSA staph infection. You may recognize MRSA from recent news reports, following a study concluding that more Americans die each year from antibiotic-resistant MRSA infections than from HIV/AIDS.

MRSA commonly spreads through hospitals, but Carey hadn't been to a hospital or doctor for months before her infection. So where did she get the potentially fatal infection?

Carey says she knows exactly where she got it — the Maricopa County Jail. She wasn't there as an inmate, but as an attorney visiting her client. She was used to inmates complaining about skin infections. Then one day after her visit, Carey noticed the zit. Two weeks later, she was in the hospital with an IV in her arm. Now, more than a year after her hospitalization, she still has a scar from the ordeal.

The damage didn't stop there. Once Carey learned about the deadly and contagious nature of MRSA infections, she paid to have her home professionally cleaned. Everything was sanitized, she was told.

Two months after Carey's battle with MRSA, her 17-year-old son asked to use her computer. Within 48 hours, he contracted the same strain of MRSA. Even with the family's early detection and knowledge about MRSA, he nearly lost his arm to the aggressive flesh-eating bacteria. He now has a two-inch scar where the infection began.

Carey is one of many Maricopa County residents who've never been booked into Sheriff Joe Arpaio's jails but who are paying dearly for conditions inside his lockups.

Vermin, filth, medical care suggestive of POW camps, chronic mismanagement, the wanton destruction of records, and a steady parade of corpses in Maricopa County jails have cost taxpayers an astonishing — and until now, undisclosed — 41.4 million dollars.

Joe Arpaio has perpetuated his reign as "America's toughest sheriff" with an open checkbook.

Your open checkbook.

The Sheriff has captured the imagination of voters with his almost cartoonish contempt for the prisoners in his charge. He's subjected inmates to pink underwear, chain gangs, and rancid bologna sandwiches, and he's garnered big wins at the polls. But Arpaio's jail policies have generated a tsunami of lawsuits from prisoners and their families.

There simply isn't another jail system in America with this history of taxpayer-financed litigation.

New York City, Los Angeles, Chicago, and Houston, for example, collectively housed more than 61,000 inmates per day last year. From 2004 through November of this year, these same county jails had a combined 43 prison-conditions lawsuits filed against them in federal courts.

In the very same three-year time frame, despite housing a mere 9,200 prisoners per day, Sheriff Arpaio was the target of a staggering 2,150 lawsuits in U.S. District Court and hundreds more in Maricopa County courts.

With a fraction of the inmate population, Arpaio has had 50 times as many lawsuits as the New York, Los Angeles, Chicago, and Houston jail systems combined.

Based on records produced under the Freedom of Information Act, a review of federal and state records and a comparison with other correctional facilities, the picture that emerges is clear: Cruelty costs.

Maricopa County Sheriff's Office spokesman Paul Chagolla refused to arrange an interview with Arpaio for this story.

Earlier this month, the front pages of local daily newspapers were dominated by stories about the sheriff exceeding his budget by a million dollars. The courthouse was shuttered for a day. Positions were slashed, and visiting hours for attorneys and court personnel were cut drastically. Naturally, that meant another lawsuit (Arpaio lost and has appealed).

County taxpayers have footed an undisclosed fortune to sustain Arpaio's image as a tough lawman. The $41.4 million taxpayers coughed up to insure for, defend, or settle lawsuits is just the edge of the cesspool — one result of inhumane conditions that have long made Arpaio's jails the target of investigations from both the federal government and advocates like Amnesty International.

Arpaio has an 11-year history of ignoring expert warnings that his jails violate basic tenets of the U.S. Constitution and threaten life and limb. At least 11 inmate deaths have directly resulted from Arpaio's refusal to heed such warnings.

In that time, the deductible for the county's insurance policy to cover lawsuits against the sheriff has jumped from $1 million to $5 million. The annual premium has quadrupled in recent years. These dollars come out of the county's coffers, not from Arpaio's annual budget of $288 million, which he's already overrunning this year.

And which is $60 million more than the sheriff budget in a county jail of similar size in Houston.

While the sheriff has long argued that his crude jails prevent crime, a study that his office commissioned, and that cost $19,900, found that Arpaio's jails have no effect on inmate recidivism.

Despite the cost, the primary victims of Arpaio's mismanagement are not taxpayers, or even attorneys like Kathleen Carey, but indigent inmates like Michelle McCollum.

McCollum, who was arrested for drug possession, could not make bail and, therefore, waited for trial in Arpaio's lockup. She eventually was sentenced to nothing more than probation.

A medical test administered when McCollum was admitted to jail confirmed that she was pregnant.

On August 22, 2005, McCollum sat on the concrete floor of the Fourth Avenue Jail, a facility un-affectionately known by inmates as "The Matrix" (because the lights never turn off). She longed for a mattress and tried hard to overlook the rotting food and soiled feminine napkins on the floor.

McCollum and another cellmate reported the beating to detention officers, pleaded for medical help, and reminded deputies that McCollum was pregnant and had been hit in the stomach. McCollum also put in a medical request to the infirmary.

No doctor or nurse looked in upon the injured McCollum.

Two days later, McCollum sat in the courthouse, chained to a row of inmates, when she started to bleed. She bled for five hours, looking frighteningly like Stephen King's infamous Carrie. The inmates chained to McCollum to await their arraignments began to complain. Detention officers ignored the prisoners.

When she arrived at the E-Pod in Sheriff Arpaio's Estrella Jail, a bloodstained McCollum again told guards about her beating and her need for medical care. An officer put in a priority request for medical attention, but nobody came. Alarmed at McCollum's loss of blood, a guard finally ushered her to see a doctor.

Infirmary workers called an ambulance and rushed McCollum to Maricopa Medical Center. Doctors there found her baby with an ultrasound, but they couldn't find the baby's heartbeat. The baby was dead.

Doctors told the jail guards that McCollum must return to the hospital in two days — on August 26 — to see if the fetus would pass on its own.

Ten days later, the jail had yet to deliver McCollum to her hospital appointment. On September 5, while McCollum stood holding her tray in the food line, the bleeding started again.

Still, nothing was done.

Three weeks after the ignored doctor's appointment, McCollum was finally rushed to the county hospital for the second time. She had lost so much blood that doctors gave her a massive blood transfusion. Then they removed the dead fetus.

It's important to note that McCollum hadn't been convicted of a crime. Like inmates whose deaths are recounted later in this story, McCollum was awaiting trial — innocent under the law.

Ignored cries for medical attention and resulting agony are not uncommon in Arpaio's jails.

"Only 40 percent of inmate sick-call requests are responded to in a timely manner . . . Because sick-call requests are not responded to in a timely manner and health appraisals are not completed within the required time frames, an inmate's health status is likely to deteriorate while in the custody of Maricopa County," concludes an audit of jail conditions done for the county two years before McCollum lost her baby.

Every sheriff gets sued over jail conditions. The problem is that Joe Arpaio gets sued thousands of times more than any of the others.

Before Arpaio's reign, Maricopa County didn't bother to pay for liability insurance. And with good reason — the county wasn't losing multimillion-dollar lawsuits or paying families millions to settle their claims.

Peter Crowley, Maricopa County's risk manager, says the county's insurance rates have skyrocketed during Arpaio's tenure. "I wasn't here back when [the Scott Norberg case] happened," Crowley says of Arpaio's first major loss, a suit the county settled for $8.25 million. "But I can tell you this: Our deductible was only $1 million a few years back. Now it's $5 million."

Early into Arpaio's reign, county officials realized they needed insurance. They were able to get a relatively cheap policy, and from 1995 to 1998, the county paid $328,894 a year for an insurance policy with a $1 million deductible.

But now, after Arpaio's lawsuits have cost the county $30 million in legal fees and cost insurance companies millions more, it pays four times as much for a policy. That policy doesn't even cover lawsuits under $5 million.

Today, Maricopa County pays a yearly premium of $1.2 million for outside insurance with a $5 million deductible. For any lawsuit that costs $5 million or less, the county foots the entire bill. It's the best policy the county can get given Arpaio's dismal track record.

Since 1995, that yearly insurance premium alone has cost taxpayers $11,345,609, according to the county's Risk Management Office. More staggering is the official grand total of Arpaio's attorney's bills, lawsuit settlements and payments: $30,039,928.

Both figures were listed in a report produced by county officials after a recent New Times public-records request. Combined, they show the cost to insure for and defend against Arpaio lawsuits totals $41.4 million.

In Joe Arpaio's jails, even the paperwork is deadly.

For $6 million, the jails could have built a computer database of inmate health problems. Such a database, advised jail auditor Moore and Associates in 2000, would improve healthcare for inmates and improve efficiency for jail employees.

Three years after that finding, a 2003 audit concluded, "Personnel report that medication errors occur on a regular basis" and "there is a significant backlog in health-record filing that has been estimated to be between eight months to one year . . . the health records are not current and continuity of care cannot be maintained."

Five years after that first warning, the jail still hadn't built an electronic database for inmate health problems.

Deborah Braillard died as a result.

She had been arrested for riding in a stolen car.

When Braillard, 46, an insulin-dependent diabetic, started shaking, vomiting, and fading into a diabetic coma, Arpaio's detention officers decided against taking her to the infirmary.

She had been in perfect health when she entered Arpaio's jail, but after two days without insulin, she was on the verge of a coma.

Numerous inmates, including Braillard's cellmates, who rattled cell bars and hollered for guards, say asking for medical treatment in Arpaio's jails often merits a reply from guards that you're faking it.

Braillard wasn't faking it.

Tamera Harper was one of three Estrella Jail cellmates of Braillard's who told an identical story of what happened next.

"I woke up to hear Deborah Braillard moaning and crying for help. The detention officers moved her to a television room to keep her from disturbing other inmates," Harper wrote in a court declaration.

The detention officers didn't take Braillard to the jail infirmary.

The cellmates all say that when officers flopped Braillard back into her bunk the next morning, January 23, 2005, she was unconscious. The inmates attempted to feed Braillard sugar, but she began convulsing.

Jail employees eventually arrived, lifted Braillard into a wheelchair, and opted for non-emergency transport to the Maricopa County Medical Center, where she was quickly transferred to the intensive care unit. Hospital doctors reversed the diabetic coma with basic insulin and fluids. But the damage was done.

When Sheriff's Detective J. Bryant arrived to check out Braillard's body, he pulled back the blue hospital blanket to note that Braillard's limbs were swollen, her toes were already black, and her calves were spotted with sores. Hospital tubes and IVs were still in her body.

The problem isn't just that the jail denied Braillard insulin and refused to treat her. It's that the jail knew Braillard was diabetic before she was even arrested.

Like many inmates, Braillard had passed through the jail months earlier. On that visit, she had marked the jail's intake sheet, declaring her diabetes. The jail's health records documented Braillard's need for insulin.

Yet, on her second incarceration, jail employees denied her insulin, ignored her cries for help, and failed to get her insulin when she became unconscious.

A shoestring budget-records system of paper folders (with misspelled and misfiled names) costs healthcare employees hours of time spent inefficiently, warned the 2000 Moore and Associates audit. It also probably cost Braillard her life.

An electronic database (as was standard in most jails of Maricopa County's size by 2005) would surely have shown Braillard was diabetic and saved her life.

Consider that Harris County (Houston), Texas, operates a jail and sheriff's department of a similar size on a budget of $60 million less than Arpaio's. Harris County is no model jail, but officials there say they've had an electronic database of inmate health concerns for years. An electronic database for Maricopa County jails was finally started in July of this year — 18 months after Braillard died and eight years after auditors advised its installation.

The $6 million database was commissioned not by Arpaio but by healthcare officials, on the advice of a third-party consulting company recently hired by the county to "turn around" jail healthcare. The database should be finished by 2012 — 13 years after it was recommended and seven years after Braillard's death.

Even without the database and even with detention officers misdiagnosing her, Braillard should not have died. Fearing the ineptitude of Arpaio's jails, Braillard's friend, Deborah Fouts, faxed a note to the jail at 9:42 p.m. the night before Braillard went into diabetic coma. The note reminded Correctional Health Services, the jail's healthcare agency, that Braillard was diabetic and would die without insulin.

"Inmate Braillard, Booking # P037486 is diabetic and has not had insulin for two days," Fouts wrote in the fax, sent to the sheriff and the jail infirmary.

So what happened? An internal Sheriff's Office report after Braillard's death concluded that the faxed note "slipped through the cracks." And with a quick point of the finger to nobody in particular, Arpaio's detectives wrapped up the investigation.

Physicians and attorneys outside the jail say it's still common for prescriptions to slip through those same cracks that killed Braillard. They say inmates are being denied medication for diabetes, seizures, high blood pressure, asthma, thyroid conditions, and mental health disorders.

Braillard's was a costly slip-up indeed, not only for her, but for the county and its taxpayers. The county now faces a wrongful-death lawsuit brought by attorney Michael Manning, who has collected more than $18 million in settlements and judgments from wrongful deaths in Arpaio's jails.

Like the thousands of other lawsuits against Arpaio, it's impossible to predict the outcome of the suit by Braillard's family. Easier to calculate are the multimillion-dollar suits Arpaio already has lost from deaths that would have been prevented if Arpaio had only listened to expert warnings.

On March 29, 2006, a $9 million court judgment was leveled against Arpaio and the county in the beating and restraint-chair death of inmate Charles Agster III.

Agster, 33 and mentally retarded, was arrested for trespassing on August 6, 2001. Detention officers at the Madison Street Jail pulled a hood over his head and slammed him into a medieval-looking restraint chair. The hood around Agster's throat smothered him to the point that he became brain dead. He was pronounced legally dead three days later on August 9, 2001.

Agster's death should have been prevented. Two years before he was killed, the county had paid $8.25 million to settle the Norberg suffocation suit. Surveillance video shows officers wrestled Scott Norberg into a restraining chair, bound his mouth with a towel, and continued to beat and Taser him after he was handcuffed. Even after the multimillion-dollar payout to Norberg's family, Arpaio kept using the chairs — costing Agster his life and the county another $9 million.

But, really, the restraint chairs should have been discarded before that first payout. Three years before the Norberg settlement, in 1996, detention expert Eugene Miller warned Arpaio, "The best recommendation I can professionally make in respect to the Restraint Chair is to remove it from any use associated with the MCSO jail."

Then in 1997, Amnesty International protested the restraint chairs — an odd move considering that Amnesty usually focuses on prison conditions in Third World countries. The U.S. Department of Justice also took Arpaio to court twice over the chairs and other concerns.

In December 2005, Clint Yarbrough died as Norberg and Agster had died — bound and suffocated in a restraint chair. On April 18, 2007, the Maricopa County Board of Supervisors approved a classified settlement in excess of $1 million to Yarbrough's family.

Norberg, Agster, and Yarbrough were never tried for the charges they were arrested on. They didn't live to see their first court dates.

These legally innocent Maricopa County residents died in Arpaio's jails because the sheriff refused to listen to expert advice.

They're not the only ones. Arpaio ignored warnings from experts about suicidal inmates, as well. Even before the sheriff was warned about understaffing, unorganized records, and restraint chairs, the Department of Justice warned him that his mental wards were unfit for suicidal inmates.

Arpaio's refusal to heed that Justice Department's warning led to at least four more preventable jail deaths.

Months before Thomas Bruce Cooley, 44, was found hanging by his bed sheets in his Madison Street Jail cell, a federal inspector told Arpaio that his psychiatric ward was a tragedy waiting to happen. The 1996 report specifically cautioned that inmates could use "overhanging structures" to hang themselves.

"Given that acutely psychotic patients are housed at Madison jail, psychiatric housing there is dangerous," the DOJ report stated. "Acute psychiatric patients should not be allowed in this unit unless major structural and staffing deficiencies are corrected."

After Cooley's death, at least three of Arpaio's other psychiatric inmates died in the same manner.

In 2003, the Arizona House of Representatives passed a bill requiring that jail healthcare meet national standards.

The Department of Justice has also required Arpaio to meet national jail standards.

But neither government body has taken steps to make sure Arpaio is meeting its standards.

And according to the county's own auditors, he isn't. They say Arpaio's jails fail to meet constitutional and state standards required by law.

In 2003, the county hired Jon Bosch, a corrections consultant with 20 years of experience, to audit Arpaio's jails.

"The current correctional healthcare program at Maricopa County is not in compliance with the basic healthcare rights provided to inmates under the U.S. Constitution," Bosch concluded. He found that Arpaio's jails violate the Eighth Amendment prohibiting "cruel and unusual punishment."

National jail inspectors like Bosch are not bleeding-heart prisoner advocates. They're a jaded breed familiar with corrections law and have spent decades walking the stinking, cramped corridors of jails. Bosch would be out of a job if he threw claims of constitutional violation around casually in the hundreds of jails he audits.

Attempts to interview Bosch, who still works as a corrections auditor, were unsuccessful.

In addition to constitutional violations, Arpaio's jails have also broken Arizona law, according to another county-hired inspector. "The Sheriff is required to verify that healthcare services are [in] compliance with nationally accepted correctional healthcare standards. The current program would not qualify," concluded the 2003 Maricopa County Correctional Health Services Staffing Proposal Draft.

Under Arizona law, Arpaio must obtain certificates showing successful inspections and keep this certification on file.

Despite the statute, when New Times asked to see these certificates, Arpaio spokesman Paul Chagolla said he could not hand them over because the sheriff no longer keeps them. In the next breath, Chagolla assured New Times that the jails do meet the required standards.

Arpaio has paid no more attention to federal mandates.

On December 6, 1999, Arpaio agreed to change a number of jail policies after federal attorneys took the sheriff to court a second time over alleged civil rights abuses.

"We have concluded that unconstitutional conditions exist at the Jails with respect to (1) the use of excessive force against inmates and (2) deliberate indifference to inmates' serious medical needs," stated a federal audit of jail conditions.

The DOJ wrote up a civil rights "settlement" that Arpaio signed.

However, records show that not once in the past seven years have the feds checked to see if Arpaio made the changes he promised.

According to local inspections, as well as complaints from inmates, Arpaio ignored the following terms of the settlement:

• "When an inmate has not received prescribed medication relating to infectious, chronic, or life-threatening conditions during a regular medication [distribution], the nurse will take appropriate action to ensure that the inmate receives the medication as soon as is feasible."

When the DOJ put Arpaio in a headlock, he cried "uncle" by claiming he had implemented a list of to-dos. But he hasn't, and the Justice Department hasn't made him.

Health code violations in Arpaio's kitchens go beyond the usual jailhouse whining about the quality of chow. The conditions cited by inspectors create a breeding climate for disease. Arpaio's mess halls routinely fail reviews by Maricopa County Environmental Services inspectors — the same inspectors who monitor restaurants and public facilities across the county.

County Attorney Andrew Thomas could literally shut down Arpaio's jails and arrest the sheriff for criminal public health violations.

That's exactly what Thomas did last year to a number of Phoenix restaurant owners whose kitchens had fewer violations than Arpaio's.

During Thomas' botched "Dirty Dining Crackdown," he pursued Tepic Restaurant's owner with criminal charges that resulted in jail time, fines and two years of probation. He also held a press conference to announce the criminal charges against the owners of Ajo Al's. The owners demanded a trial; Thomas lost.

Another targeted restaurant during this campaign had only four violations. Meanwhile, a single one of Arpaio's jail kitchens has netted more than 30 such violations in the past two years.

Here's a glimpse into Arpaio's kitchens based on county inspection reports from Environmental Services:

• Roaches are frequently spotted swarming behind major appliances, scuttling through food-preparation stations and lurking where food is stored. The presence of flies and rodents is routine.

• "Pest control is not properly performed," noted one report dryly.

• Just as prevalent are piles of rodent excrement and nests polluting food areas. More alarming, inspectors repeatedly note the presence of rodents and rodent feces in the water wells.

While chain gangs outside the jail garner national publicity for Sheriff Joe, his captive pool of labor is not directed to clean the festering conditions inside the jails. Instead, this cesspool breeds contagious infections that healthcare employees can only hope to contain.

When Arpaio's culture of violence has produced corpses and lawsuits, his staff has destroyed records and faked documents repeatedly.

In fact, Arpaio's first major legal payout of $8.25 million came as the result of obvious records tampering by the Sheriff's Office. Attorney Mike Manning had smoking-gun proof that jail employees fabricated a fake health intake report for Scott Norberg (who died after being beaten by guards and strapped into a restraint chair). Not only that, but half of Norberg's postmortem X-rays were missing, and his name was deleted from the X-ray logbook.

So conclusive was the proof of records destruction that the county opted to pay Norberg's family to drop the case. In other words, the county's legal experts looked at the evidence of records-tampering and decided they would be better off not letting the case get to court.

A further obvious effort to destroy records was proved in March 2006, when Arpaio lost a wrongful-death suit filed by the family of Charles Agster III.

During the Agster court case, jail nurse Betty Lewis testified that jail authorities commanded her to create a series of false documents after Agster's death. Some of Agster's health records also disappeared from the jail, and his falsified booking number didn't exist until the day after he was transferred out of the jail into the hospital.

The Agster case also documented a second nurse who collaborated with sheriff's detention officers to make up fake entries and notes after Agster's death.

Next month, on January 8, 2008, a trial is scheduled in Maricopa Superior Court in a lawsuit filed by deceased inmate Brian Crenshaw's family. The family can't present jail-records evidence because the Sheriff's Office destroyed it — even after the court ordered it to hand over the evidence.

Crenshaw, 40, was legally blind and serving a short sentence in Tent City for shoplifting. After a documented struggle with Arpaio's detention officers, Crenshaw was transferred to solitary confinement at the Madison Street Jail. Six days later, he was found comatose in his cell with a broken neck, ruptured intestines, broken toes, and severe internal injuries.

Only sheriff's guards had contact with Crenshaw in his cell, but Arpaio still maintains that Crenshaw sustained the life-ending injuries when he fell off his four-foot bed.

On September 26, 2006, the court ordered Arpaio's office to produce the jail's videotaped recordings that lawyers suspected would have shown officers beating Crenshaw. Then, on August 31, 2007, nearly a year later, the sheriff's attorney replied that the records had been destroyed — even after multiple requests and court orders to preserve the videotapes.

In November, New Times requested information about antibiotic-resistant MRSA staph infections and inmate-reported spider bites (which national jail experts say are often actually MRSA or other staph infections) among inmates.

Somehow, jail healthcare officials say they have recorded "zero" spider bites when asked in the context of deadly and contagious MRSA staph infections. Yet inmates "routinely" complain about spider bites when asked in the context of a puff story highlighting animals in the jail.

"In court, you'll often see detention officers wearing gloves. That's because they don't want to catch MRSA from the inmates," Carey says.

Jail healthcare directors reported 41 incidents of "lab confirmed" MRSA infections in the 2006-07 fiscal year. They also reported "zero" spider bites from 2004 to 2007. At the same time, multiple caseworkers, attorneys, and inmates have reported rampant skin infections and spider bites in the jails.

Attorney Carey is living proof that infectious diseases aren't confined behind bars. They spread to the general public from the jail through lawyers, guards, caseworkers, hospitals, courtrooms, and released inmates.

Other counties and the Centers for Disease Control have targeted MRSA in jails, but jail healthcare officials refuse to produce a policy on the flesh-eating bacteria — if they have one.

Interim Correctional Health director Adams told New Times, "CHS does not maintain a database that shows the number or frequency of categories of health concerns."

Adams then canceled a previously scheduled interview with New Times to discuss MRSA and other infectious diseases among inmates. She also didn't produce requested records of MRSA-related deaths in the jails.

Even without official statistics, it isn't hard to confirm that MRSA is killing inmates. Dr. Patrick O'Neill is one of the last doctors to see patients dying of MRSA at the Maricopa Medical Center, where Arpaio's office sends dying inmates.

O'Neill says, "The majority of [MRSA] patients I see will come from jail, either the sheriff's or the prison system's. You also have to realize the ones I see are the most severe cases. There could be a whole other class of patients that our ER guys see, whereas I only see the nearly dying."

Requests to interview county hospital emergency room physician Dr. Frank LoVecchio went unanswered. But there's good reason to believe LoVecchio sees MRSA cases, as well. He just received an $8.9 million federal grant to study MRSA infections.

O'Neil says patients who don't die from organ failure or other MRSA-related causes require amputation or skin excising. "I only typically see patients who are sick enough to require the inpatient hospitalization and treatment. So there are a whole lot more who have the less-complicated skin and skin-structure infections," O'Neil says.

O'Neil wouldn't estimate the actual number of MRSA patients he sees, from the jails or otherwise, but he says, "I do know that it's increasing, and it's something we're very aware of."

Former inmate Jay Carey had an MRSA infection when he entered the jail. Despite telling jail employees about the contagious and deadly infection, he says he was left in the general jail population and didn't see a jail physician until the day before his release.

In a court complaint, Carey also says a jail nurse then told him and his attorney, "We handle these MRSA cases all the time. We know what we're doing."

In all fairness, MRSA thrives in jails and prisons across the country. It's just that other jails are doing something about the problem. For example:

• Los Angeles County Jail authorities identified MRSA as a major problem in 2002, and invited federal and clinical researchers in to help study and contain the MRSA "superbug."

• In October of this year, the Tulsa County Jail in Oklahoma scrubbed its entire 1,700-cell facility with a chemical bacteria killer that targeted MRSA.

• County jails in Kentucky created a MRSA training course so corrections officers can identify MRSA-infected inmates within 24 hours and take them to health officials.

Meanwhile, Maricopa County inmates report skin infections weeks before treatment — if they get medical attention at all. As the infections ooze, they contaminate the overcrowded cells and spread to other inmates.

Recent figures estimate that 70 percent of inmates are pretrial detainees. Meaning many of them will soon walk out of court hearings and back to their lives outside jail.

One inmate tells of getting the infection on her buttock after she sat on a toilet in the jail. Inmates with skin infections interviewed for this story reported a two-to-three-week wait to see a jail physician — even after filling out medical requests to report staph or skin infections.

"The operation of the jail facilities is a constitutional mandate of the sheriff and the delivery of medical services within the jail system falls within that constitutional mandate," Arpaio wrote in an October 7, 2004, memo to the County Board of Supervisors.

This proves that Sheriff Joe Arpaio clearly understands that he is responsible for the conditions in his jails — even though he does little to improve them.

The decrepit health and sanitary conditions within Arpaio's jails breed lawsuits as well as disease.

The cost to taxpayers to finance this culture of cruelty is $41.4 million, and counting.

The $41.4 million is just the edge of the cesspool — a single result of standards that have long made Arpaio's jails the target of investigations from both the federal government and advocates like Amnesty International.